The subject matter described herein generally relates to instruments adapted to assist in conducting one or more tasks associated with the course of a medical examination. The instruments provided herein, further present a convenient, economical method to conduct a preliminary medical examination in one's own home. Therefore, with the consistently rising costs of health care and the hassles involved with hospital visits, one benefits from making the most out of an at-home medical examination before seeking professional medical advice. In some instances, a hospital visit may not be necessary once an at-home medical examination has been performed.
Various types of childhood illnesses occur often during a child's life, and can present a financial strain on the guardian of the child. According to the American Chiropractic Association (ACA), 10 million new cases of ear problems in children occur every year (see at: www.acatoday.org/content_css.cfm?CID=69). Ear infections (otitis media) are the most common illness affecting babies and young children and the number one reason for visits to the pediatrician, which accounts for more than 35 percent of all pediatric visits. Almost half of all children will have at least one middle ear infection before they're a year old, and two-thirds of them will have had at least one such infection by age 3. Children are more prone to ear infections because the immune system, which protects the body against infectious organisms, is not yet fully developed in young children. When a baby is born, the immune system is stimulated by the exposure to new germs and begins to produce antibodies. The immune system continues to grow as it is exposed to new germs. However, if a baby is encountering a new germ for the first time, antibodies have not yet formed. As a result, young children are more prone to infections than adults. The symptoms of an ear infection can include ear pain, fever, and irritability. While they occur more often in children, middle ear infections can also occur in adults. Therefore, an early diagnosis of such an infection can prevent unnecessary pain and suffering in a patient.
Ears are made up of several parts, including the outer ear (auricle and ear canal), middle ear, and inner ear. The auricle can be easily damaged as it is skin-covered cartilage with only a thin padding of connective tissue. Therefore, any trauma to the ear can cause enough swelling to jeopardize the blood supply to its framework, i.e., the auricular cartilage. The ear canal can be injured as a result of exposure to firecrackers and other explosives, or as a result of mechanical trauma from placement of foreign bodies into the ear. Like outer ear trauma, middle ear trauma most often comes from blast injuries and insertion of foreign objects into the ear, wherein inner ear trauma is primarily caused by either exposure to elevated sound levels (noise trauma) or by exposure to drugs and other substances (ototoxicity). Because ear trauma can occur with the insertion of foreign object into the ear, the medical instruments used (i.e., otoscopes) to examine ears must be sensitive to the size and shape of the particular ear which is being examined in order to prevent injury. The ear canals of a child and an adult are different; two major differences are the shape and size of each.
External ear development is a lengthy and complex process which extends from early embryonic life until well into the postnatal period. Initial development of the auricle and external auditory canal during the fourth and fifth weeks of gestation is closely associated with anatomical changes involving the pharyngeal arch apparatus of the human embryo. The auricle and external canal are well formed by the time of birth but do not attain their full size and adult configuration until about 9 years of age. The newborn canal is relatively straight and is considerably shorter and narrower than the canal of an adult. The length of the newborn canal ranges from 13 to 22 mm and the average diameter of the canal is approximately 4.5 mm. In an adult, the ear canal has an S shape. Adult canals have a length of approximately 30 mm and a diameter of approximately 10 mm. Volume of the ear canal is larger in boys than in girls, and the volume is greater in the right ear than in the left ear. The volume of the ear canal of a toddler is between 0.2 and 1.0 ml. The volume of the ear canal of an adult is between 0.9 and 2.0 ml.
The composition of the ear canal changes as the child grows, with the most dramatic growth of the ear canal in the first year. In the newborn, the canal wall is surrounded by elastic cartilage. This causes the newborn canal to be very flexible, yet delicate. Because it is flexible, it is easier to insert a foreign object (specula) too deep into the canal. As the ossicular bone density in newborns is low, the ear canal is more prone to trauma. Once the child reaches approximately four months of age, the canal ossifies and bone has grown around much of the canal. In the adult, only the most lateral third of the canal wall is composed of elastic cartilage, while the medial two-thirds of the canal are encompassed by temporal bone.
Due to the delicacy of the ear as an organ as well as the potential for injury, any contact with the ear must be carefully undertaken and differences in the size, shape, and composition of the ear during the various stages of life must be considered.